早卵泡期长方案控制性促排卵E_2水平下降对IVF-ET助孕结局的影响  

The influence of E_2 level decreased on the outcomes of IVF-ET of the women with controlled ovarian hyperstimulation by long protocol at early follicular stage

作　　者：刘曼曼[1] 刘艳丽[1] 管一春[1] 杜明泽 刘文霞[1] 王碧君 王兴玲[1] LIU Manman;LIU Yanli;GUAN Yichun;DU Mingze;LIU Wenxia;WANG Bijun;WANG Xingling(The Third Hospital Affiliated to Zhengzhou University,Henan Province,450052)

机构地区：[1]郑州大学第三附属医院,450052

出　　处：《中国计划生育学杂志》2019年第5期636-639,共4页Chinese Journal of Family Planning

基　　金：2018年度河南省卫生计生科技英才海外研修工程:PGD活检技术质量控制平台的完善与临床应用项目(2018070)

摘　　要：目的:探讨早卵泡期长方案控制性促排卵(COH)雌二醇(E_2)水平下降对体外受精-胚胎移植(IVF-ET)的结局影响。方法:回顾性分析IVF-ET时COH过程中E_2水平下降(观察组289例)及E_2持续上升(对照组292例)患者的临床资料,分别按照E_2下降的原因及下降幅度分组,比较各组间的助孕结局。结果:IVF-ET治疗hCG日,E_2水平自发性下降组<Gn减量下降组<对照组,E_2下降的幅度、获卵数及2PN率自发性下降组低于Gn减量下降组(均P<0.05);hCG日P水平、2PN卵裂率、优胚率、移植胚胎数、临床妊娠率及早期流产率在自发性下降组、减量下降组、对照组间比较无差异(P>0.05)。hCG日E_2水平在E_2下降幅度20%组最低,对照组最高,下降幅度10%～20%组和>20%组的获卵数低于下降幅度<10%组及对照组(均P<0.05),E_2下降幅度>20%组2PN率及优胚率均低于其余各组(P<0.05)。结论:早卵泡期长方案COH中E_2自发性下降及下降幅度>20%可能会降低周期获卵数及优胚率,但未影响临床妊娠率。Objective: To influence of falling estradiol (E 2) level decreased on the outcomes of In vitro fertilization-embryo transfer (IVF-ET) of the women with controlled ovarian hyperstimulation (COH) by long protocol at early follicular stage. Methods: The clinical data of patients with E 2 level decreased (in study group) and the patients with E 2 level increased (in control group) during controlled ovarian hyperstimulation (COH) were retrospective analyzed. The pregnancy outcomes of women were compared. Results: The E 2 level on HCG day of women in study group was significant lower than that of women in control group. And In study group, the E 2 level of women without Gn decreased was significant lower than that of women with Gn decreased ( P <0.05), and the degree of E 2 level decreased, the number of retrieved oocytes, and the rate of 2PN of women with Gn decreased were significant lower than those of women without Gn decreased ( P <0.05). There were no significant differences in level of P on HCG day, 2PN cleavage rate, high quality embryo rate, embryo number of transplantation, clinical pregnancy rate, and early abortion rate between the two groups ( P >0.05). The 2PN cleavage rate or high quality embryo rate of women with over 20% E 2 level decreased on HCG day was highest ( P <0.05). Conclusion: When the spontaneous decreasing of E 2 level of women with COH by long protocol is over 20%, it maybe reduce the number of retrieved oocytes and rate of high quality embryo, but it hasn’t influence on the clinical pregnancy rate.

关 键 词：体外受精-胚胎移植 单卵泡期长方案 控制性超促排卵 雌二醇 妊娠结局 

分 类 号：R714.8[医药卫生—妇产科学]